PTSD among first-responders real, treatable

VERO BEACH – When officials with the International Association of Firefighters learned they'd lost a beloved member to suicide on Saturday who'd suffered with post-traumatic stress disorder, they acknowledged the grim fact that many emergency first-responders struggle with PTSD.

And just as grim, mental health experts say, is the stigma attached to seeking help that stops many firefighters, police and paramedics from reaching out for professional assistance.

Kimberlee Marcil-Wieleba, a licensed clinical social worker with a private practice in Vero Beach, said the long-term nature of exposure to traumatic events on the job is a big factor for first-responders.

"The whole stigma of getting help is still a major issue," Marcil-Wieleba said. "It makes the treatment picture more complicated."

On Saturday night, Indian River County Fire Rescue Battalion Chief David Dangerfield, 48, drove to a rural area of the county and shot himself. His family this week said Dangerfield had been committed to the PTSD counseling he'd been receiving up to three times a week for more than a year.

"Our fire service family is completely heartbroken over the loss of one of our most deeply respected, highly trained and incredibly beloved chiefs," John O'Connor, president of IAFF Local 2221, said Monday. "Dangerfield ... left a very telling Facebook post, written just hours before his death, that speaks volumes:

'PTSD for Firefighters is real. If your loved one is experiencing signs get them help quickly. 27 years of deaths and babies dying in your hands is a memory that you will never get rid of. It haunted me daily until now. My love to my crews. Be safe, take care. I love you all.'"

Added O'Connor: "With his family's blessing, we cannot ignore David's last known words. PTSD is becoming more widely recognized as a major issue among firefighters, even though it has always existed. We as a fire service family are working hard to break the stigma attached to asking for help. We can only hope that David's passing will remind those in pain to seek help before it's too late."

A memorial service has been scheduled for 11 a.m. Saturday at Community Church, 1901 23rd St., Vero Beach.

O'Connor said their goal now is "to do the best we can to make sure this never happens again."

"If someone is showing signs or symptoms that they need assistance," he said, "we are going to do the best job we can to make sure they get the tools that they need."

RED FLAGS

O'Connor noted the job-related trauma inflicted on firefighters and other first-responders can trigger the same behavior problems seen in military veterans, but with a difference.

"The military, they have really high intensity exposure to traumatic events. We tend to have traumatic exposure but not as high intensity, but over longer periods ... it kind of sneaks up on you," he said. "So we are trying to learn as much as we can on recognizing the signs and symptoms of it. And we're trying to break the stigma of, 'I'm alright, I don't need any help, I'm tough.' We are really trying to break that stigma, and that has been ingrained in the fire service since it's been around."

He said they're in negotiations with Indian River County officials to improve services available to their union members "and to get anyone help that they need."

Marcil-Wieleba said talk therapy with a trusted person helps, and medication can curb symptoms of depression and anxiety.

Still, just admitting there's anything wrong can be a milestone for anyone struggling with PTSD, she said.

"For them to even walk into my office ... is a huge, huge step," she said. "Typically, they've been suffering for a very, very long time. And often first-responders come to me because their spouse has really, really pushed them to do so."

Early symptoms typically show up in mood disturbances, she said, including anger, trouble concentrating or sleeping, being easily startled, or feeling edgy or numb.

"People will also start to have intrusive memories, where they have recurrent, unwanted distressing memories of the events – the flashbacks," she said. "One of the things I've observed in my practice over the years is the higher up in command a first-responder is, the less likely they will be to seek help.

"It's the stigma involved," she added. "They feel like they have to be strong, a good role model for their department."

DEFUSING THE STRESS

O'Connor said Indian River County Fire Rescue doesn't maintain what's known as a Critical Incident Stress Management team, but it taps into teams in place with Martin County Fire Rescue and the St. Lucie County Fire District.

The volunteer team, consisting of clergy and professionals in nursing and mental health, may be called into action following any traumatic incident first-responders experience. The purpose is to offer immediate intervention following a violent incident or tragedy involving children to help minimize stress-related symptoms.

Martin County Fire Rescue Bureau Chief Dan Harshburger said his department has reached out to colleagues in Indian River to offer the use of its critical stress team.

"We are always here for them in any capacity that they could possibly want us for," Harshburger said.

Fire-rescue personnel in St. Lucie County also offered the use of its critical stress team. Chief Buddy Emerson said the group has received suicide awareness information as part of a critical incident stress debriefing.

"There were over 100 officers who were asked to bring the word to their crew members," Emerson noted in an email.

He said in December, they plan to host a mental health expert who will focus on PTSD.